Balancing Psychological Safety with Need for Confident Voices in Teams

In recent workshops on “Game Changing Experiential Activities for Interprofessional Team Development:  1 Activity at a Time”, offered through Dartmouth Health in May 2023, some discussion emerged about teaching activities. At this point in the online program, the group had learned about experiential teaching process for soft skills and participated in a variety of activities. In breakout sessions they were asked to develop ‘lesson plans’ using the activities.

Note: these activities are inherently interactive and require everyone’s participation. Radical Acceptance, for example, involves each person naming 3 things in a category, such as fruit, while the group responds affirmatively and with increasing enthusiasm after each one.  Quite simple intellectually yet can feel risky with respect to social and emotional learning.  

Two perspectives were expressed re: knowing your team members’ comfort levels and whether or not to teach a particular activity.  Time ran out before we could fully explore the tension between these trains of thought.  

Two Perspectives

One point of view was that it was important to know your audience and whether or not they would be comfortable participating. If not, don’t use the activity.  The other viewpoint was that people needed to have some experience with an activity in order to experience how fun it could be and to develop confidence in participating.  In this case, participants’ lack of comfort should not be a deterrent. 

Image by Hands off my tags! Michael Gaida from Pixabay

Third Option

While we need to make experiential activities as psychologically safe as possible for everyone, we also need to be willing and able to gently nudge people into their stretch zone where deep emotional learning such as developing confidence can occur. 

I recommend facilitators, educators, and leaders of healthcare teams learn how to minimize the risk AND gently nudge folks into their ‘stretch’ zones.

3 Key Reasons!

First, everyone’s voice on a given healthcare team is important!  Different experiences, expertise, observations, and relationships with patients are all potentially helpful, even critical for providing safe, compassionate care.  All too often, teams have implicit cultures where a few voices are expressed and heard. Such a culture may also extend throughout an organization.   Those of you who study Sentinel Events know this is a dangerous, toxic problem.  

Second, fears associated with public speaking are well-established yet developing confidence about speaking up requires experience and practice in speaking up.  Another element of these activities is that when someone speaks up they are heard and affirmed by others.  This typically results in a positive, even fun feedback loop that is especially helpful in developing confidence (as well as practice validating others). 

Third, as facilitators, educators, and/or leaders we need to be aware of the possibility our own needs or fears are leaking into the decision.  For example, our own need for belonging or desire to be liked by a team may make make us reluctant to push people in ways where we sense a backlash.  It is good to be aware of such hesitations.

In this same vein, facilitating experiential activities is different from teaching clinical skills, the mechanics of new equipment, or pharmaceutical information.  It can feel awkward and risky.  While these, concerns are worthy of attention, they aren’t good reasons to avoid bringing these valuable learning opportunities to teams and organizations. 

In my book, Medical Improv: A New Way to Improve Communication, I talk about a variety of teaching tips that can help.  (Owning some awkwardness and asking for cooperation with trying something new and different is an example!) 

Conclusion

While honoring people’s range of social and emotional comfort level is important, instead of asking whether or not an activity should be taught, a more appropriate question is; what can I do to make an activity as safe as possible so that everyone has a positive experience in speaking up and listening?   Tips for lowering the risk for Radical Acceptance include: doing an activity in pairs rather than with the full team, naming one or two things rather than three, repeating the same thing 3 times, and modeling making a mistake!  Practicing with a small and willing group of colleagues or getting some help teaching are also alternatives.

I discuss facilitating Radical Acceptance in more depth:

• Simple Activity for Profound Individual & Team Development
• Affirmation Activity for Healthcare Teams

If you would like to talk about bringing a high impact, low cost “Game Changing” program to your management or faculty team please reach out to beth@bethboynton.com. Learn how a handful of activities can be used a few minutes at a time to make communication and team building part of the culture.